Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1831290063

Certified Registered Nurse Anesthetist

Unknown Individual is a healthcare provider. based in Dallas, Texas. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 042362 (TX). The NPI Number for Unknown Individual is 1831290063

Main info

Organization

Inactive

35 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1831290063

Phone

(214) 324-6100

Address

9440 POPPY DR

Deactivation Date

8 November 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4692040702

Graduation Year

1991 (35 years ago)

PAC ID

6800876871

Group Practice PAC ID

7315850351

Professional Enrollment ID

I20040721000555

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

City Hospital at White Rock, 9440, Poppy Drive, Oaks White Rock, Dallas, TX, Dallas, Dallas County, Texas, 75218, United States
DALLAS, TX 752183652
Phone: (214) 324-6100
Type: Location
1721, Analog Drive, Richardson, Dallas County, Texas, 75081, United States
RICHARDSON, TX 750811944
Phone: (972) 276-6100
Fax: (972) 276-1231
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75218)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 7315850351View full group profile

Name	Specialty	State
EDITHA A FLEMMING (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
MR. JOHN PAUL SCHREINER (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
DR. ELVIS TSANG (MD)	A N E S T H E S I O L O G Y	TX
ADAM PEEPLES (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
ALYSSA ESTILL (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
LAUREN CARTER SEGERSON (CRNA)	Certified Registered Nurse Anesthetist (Crna)	TX
MICHAEL D HENDERSON (MD)	-	TX
DR. MAHEEN ADAM WARDAK (MD)	-	TX
DR. KAPIL KASHYAP (M.D.)	-	TX
DR. KEITH NEAL SUMNER (M.D.)	A N E S T H E S I O L O G Y	TX